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DSH510006B UNITED HOSPITAL CENTER (Active)
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Main Details
Name
UNITED HOSPITAL CENTER
Subdivision Name
Wound Care Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH510006B
Medicare Provider Number
510006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/5/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/26/2016
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
United Hospital Center
James Rutkowski, VP Finance/CFO
(681) 342-1605
Primary Contact
United Hospital Center
Carlton K. Hoskinson Jr., Director
(681) 342-1560
Addresses
Street Address
916W MAIN ST
BRIDGEPORT, WV 26330-1651
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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